September 2018 Podiatry Newsletter

How to Care for a Nail Bed after Trauma

Have you ever had your finger accidentally slammed in a door? Have you ever stubbed your toe so hard that the nail fell off? A fingernail or a toenail can be injured by traumatic events such as these and this kind of trauma often results in blood buildup under the nail, a torn or split nail, a splinter under the nail, or total nail loss. To prevent nail trauma, keep your fingernails trimmed and do not bite your nails or cuticles, as well as wearing properly sized shoes on your feet. Nail bed injuries are extremely painful and hinder the fingers and toes so we urge you to exercise caution while using them.

Specific Nail Injuries

  • Subungual hematoma – appears dark red under the nail as a result of trapped blood under the nail bed. Symptoms include throbbing pain and the nail turning black and blue.
  • Nail bed laceration – occurs when the nail and the underlying nail bed get cut. This is usually caused by cutting your finger with a knife or crushing it somehow. If you have a nail bed laceration, it may bleed and you may develop a large bruise.
  • Nail bed avulsion – occurs when the nail and part of the nail bed pull away from the rest of the finger. It typically is the result of your finger getting stuck or jammed in something. Nail bed avulsion will cause the finger to swell and is usually accompanied by a finger fracture.

Nail Bed Repair and Treatment

Repairing a nail bed injury will differ depending on the type of injury. Your doctor may ask how the injury occurred and X-rays may be taken to check for broken bones in the finger, foot, or ankle. The goal in treating nail injuries is to restore the nail back to its original state. Though some nail bed injuries can be fully repaired, some may result in a deformed nail if the base of the nail bed is injured.

The common treatments for nail bed injuries include:

  • For a subungual hematoma – Your doctor or podiatrist may use a needle to drill a small hole in the nail to relieve pain and pressure. If the blood surrounding the nail exceeds 50 percent, the nail bed may be removed and stitches will be placed.
  • For a nail bed laceration – Because a laceration creates a gap in the nail this injury might need stitches. If the laceration is critical, the nail may need to be completely removed.
  • For a nail bed avulsion – This type of injury requires removing the nail. If the finger was fractured, it will need to be splinted for up to three weeks.

When to Call a Professional

If your injury is minor, you should be able to treat it at home with antibiotics and bandages. However, if you have a deep cut in your nail bed you should seek professional care if it does not stop bleeding. If your finger is very swollen and painful, you should also seek medical attention. If you experience a nail injury, make sure that your tetanus vaccination is up to date to prevent illness and infection.

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